The penoscrotal surgical approach for inflatable penile prosthesis placement

Gupta, Nikhil; Ring, Joshua; Trost, Landon; Wilson, Steven K.; Köhler, Tobias

doi:10.21037/tau.2017.07.32

Cited by 50 publications

(20 citation statements)

References 13 publications

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“…In patients undergoing an IPP, a postoperative infection rate of 1%–3% has been previously reported. [ 2 4 5 ] Our post operative infection rate (2.5%) compares favourably. Also, the blind placement of the reservoir into the space of Retzius may be complicated by postoperative inguinal hernia,.…”

Section: Discussionmentioning

confidence: 73%

A novel technique for direct visualization of reservoir placement for penoscrotal inflatable penile prostheses using a single incision

et al. 2018

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Introduction:We aim to present a modified technique and outcomes of a novel method allowing for direct visualization of the reservoir placement during a penoscrotal inflatable penile prosthesis (IPP).Methods:Out of165 patients who underwent IPP placement from August 2012 to March 2015, 157 underwent a modified technique and comprised the cohort of this study. A Deaver's retractor was placed lateral to the penis and over the pubic bone to allow for direct visualization of the tissues overlying the lower abdomen. After dissecting through the superficial layers, the Deaver's was slowly advanced, allowing for visualization of the fascia, which was incised. Using blunt dissection, a space for the reservoir was created between the bladder and the pubic bone. The reservoir was then placed safely into this space and the Deaver's retractor was removed.Results:The causes of ED in the study cohort included postprostatectomy ED (n = 107), organic impotence (n = 40), Peyronie's disease (n = 3), ED following cystoprostatectomy (n = 2), ED due to spinal cord injury (n = 2), ED resulting from priapism (n = 2), and ED after pelvic injury (n = 1); all of which were refractory to medical management. The median age of study population was 66 years and the mean (standard deviation) operative time was 72.8 (14.7) min. Eighty percent of the procedures were performed on outpatient basis. Complication rates were low (<5%), with four infections, one proximal pump migration, one scrotal hematoma, and one urinary tract infection.Conclusion:The modified technique for placement of the IPP's spherical reservoir under direct visualization through a penoscrotal incision is quick, safe, and effective.

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Section: Discussionmentioning

confidence: 73%

A novel technique for direct visualization of reservoir placement for penoscrotal inflatable penile prostheses using a single incision

et al. 2018

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“…Historically, a variety of compressive tape dressings have been described by IPP implanters in an effort to provide wound coverage and facilitate hemostasis. 8 Many of these have been either too cumbersome or potentially harmful, leading in some instances to penile necrosis, as with the Coban-based “Soft Cast.” 7 …”

Section: Discussionmentioning

confidence: 99%

Novel protective penile collar following inflatable penile prosthesis placement: The “Wang Collar”

et al. 2020

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Penile rehabilitation after inflatable penile prosthesis (IPP) implantation for the treatment of erectile dysfunction includes leaving the device partially inflated so as to preserve the penile length and to maintain hemostasis. With a partially inflated device, the penis becomes more sensitive and more susceptible to unintended insults during the immediate postoperative management. The “Wang Collar,” a device intended to protect the penis in the early postoperative period, is hereby described. Three hundred and forty-eight patients had the “Wang Collar” included as part of their post-IPP management from August 2014 to February 2019. The protective collar, devised from a polystyrene cup with the bottom removed, is secured with a tape over the previously dressed and partially inflated penis. In order to evaluate the effectiveness of this device, we conducted surveys on the perioperative staff at three different institutions. The “Wang Collar” has been found to be beneficial in the early postoperative care of patients. Based on the answers to our questionnaire, the perioperative personnel found this device to be highly protective, especially when transporting the patient after IPP surgery, easy to work with, and almost never bothersome or irritative to the patient. We present a novel penile device after IPP placement, which we have found to improve patient satisfaction in the postoperative period. In addition, it eases the care of the patient by the perioperative staff. It is now our routine to use this device after IPP surgery. Further research is necessary to evaluate whether this device can decrease postoperative wound complications.

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“…Given the patient's young age, extra caution was taken to reduce the risk of infection and device herniation or injury. Evidence has shown that multilayer dartos closure may be associated with improved patient satisfaction and may help prevent future complications 7, 8. Furthermore, the use of Metzenbaum scissors to aid in distal corporal dilation has been reported to be a suitable technique 9 .…”

Section: Discussionmentioning

confidence: 99%

Successful Use of an Inflatable Penile Prosthesis for the Treatment of Distal Deficiency of the Tunica Albuginea and Cavernous Tissue

Punjani¹,

McGarry²,

Brock³

2018

Sexual Medicine

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The penoscrotal surgical approach for inflatable penile prosthesis placement

Cited by 50 publications

References 13 publications

A novel technique for direct visualization of reservoir placement for penoscrotal inflatable penile prostheses using a single incision

A novel technique for direct visualization of reservoir placement for penoscrotal inflatable penile prostheses using a single incision

Novel protective penile collar following inflatable penile prosthesis placement: The “Wang Collar”

Successful Use of an Inflatable Penile Prosthesis for the Treatment of Distal Deficiency of the Tunica Albuginea and Cavernous Tissue

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